Racial Differences in Ambulatory Blood Pressure and Echocardiographic Left Ventricular Geometry

Olutade, Babatunde; Gbadebo, T. David; Porter, Vivian D.; Wilkening, Beth; Hall, W. Dallas

doi:10.1097/00000441-199802000-00006

Cited by 14 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Similarly, a recent study in Atlanta, Ga, found less nocturnal fall in SBP and DBP in blacks. 28 These authors also found that fewer blacks than whites were classified as dippers, using the criteria proposed by O'Brien et al 19 In another study conducted in Chicago, blacks were found to have smaller diurnal change in SBP. Although blacks had higher average ABPM values, the difference between blacks and whites was greater during sleep than while awake.…”

Section: Discussionmentioning

confidence: 95%

Race and Diurnal Blood Pressure Patterns

1999

View full text Add to dashboard Cite

Abstract-Investigators have reported variable findings regarding the role of race in diurnal blood pressure patterns. We performed a review and meta-analysis of this literature to identify the overall effect of race on circadian blood pressure patterns. Eighteen studies involving 2852 participants were reviewed. Meta-analyses were conducted using effect sizes calculated from the data provided directly in the study reports. Separate meta-analyses were conducted on effect sizes for differences between blacks and whites in daytime and nighttime systolic and diastolic blood pressure and nocturnal dip in systolic and diastolic blood pressure. To evaluate discrepancies in findings from studies involving American versus non-American blacks, overall meta-analyses as well as within-subset meta-analyses of black/white differences were conducted for comparisons involving American and non-American blacks. Results of overall meta-analyses indicate that blacks experience higher levels of systolic and diastolic blood pressure, both at night and during the day. These differences were significantly greater at night than during the day (PϽ0.05). Results of within-subset analyses involving American blacks mirrored those for all black/white comparisons, except that the effect of race on nocturnal dip, ie, that American blacks experienced less of a dip in both systolic and diastolic blood pressure at night, was significant (PϽ0.05). In contrast, the effect of race on nocturnal dip was not significant for comparisons involving non-American blacks. These results suggest a consistent difference in the chronobiology of blood pressure, particularly in American blacks. (Hypertension. 1999;33:1099-1104.)

show abstract

Section: Discussionmentioning

confidence: 95%

Race and Diurnal Blood Pressure Patterns

1999

View full text Add to dashboard Cite

show abstract

“…24,25 Hypertensive blacks also have an increased prevalence of concentric remodeling and concentric hypertrophy of the left ventricle. 26 The purpose of this study was to evaluate the relationship between the anthropomorphic and metabolic components of the insulin resistance syndrome and both blood pressure and blood pressure-related target organ damage in blacks and in white French Canadians with essential hypertension. These studies were carried out in conjunction with our protocols for studying the genetic determinants of hypertension.…”

mentioning

confidence: 99%

Predictors of Target Organ Damage in Hypertensive Blacks and Whites

et al. 2001

View full text Add to dashboard Cite

Abstract-The purpose of this study was to evaluate the association of the insulin resistance syndrome with both blood pressure and target organ damage in blacks and whites with essential hypertension. Eighty-two black and 63 white French Canadian patients were studied. None had diabetes, and antihypertensive medications had been discontinued for Ն1 week. Key Words: hypertrophy Ⅲ glomerular filtration rate Ⅲ insulin resistance Ⅲ microalbumin Ⅲ race Ⅲ target organ damage R esistance to insulin-stimulated glucose uptake is a complex phenotype with both genetic and lifestyle contributory factors. The insulin resistance syndrome includes central obesity, hyperinsulinemia, dyslipidemia, hypertension, hypercoagulability, and an increased potential for developing atherosclerotic disease. 1 The possibility that insulin resistance and hyperinsulinemia may contribute to elevated arterial pressure in patients with essential hypertension has generated considerable interest, and a number of putative mechanisms have been proposed. 2-4 However, results of epidemiological and clinical studies describing the relationship of insulin resistance and/or hyperinsulinemia to hypertension or to the development of hypertension are conflicting. 5 Some reports suggest that the relationship between insulin resistance and hypertension is less striking in blacks than in whites. 6 Among hypertensives, both renal disease and cardiac disease have been related to the insulin resistance syndrome. Microalbuminuria is a strong predictor of cardiovascular and renal disease risk. 7 Several 8 -10 but not all 11,12 reports describe an association of plasma insulin concentrations and/or indexes of insulin resistance with microalbuminuria. Glomerular hyperfiltration, a functional renal change that precedes glomerulosclerosis, 13-15 is associated with obesity, 16 and obesity augments the effect of hypertension on albuminuria. 17 Furthermore, in obese hypertensives, higher glomerular filtration rate (GFR) is associated with insulin resistance. 18 Insulin exerts a growth-stimulating effect on cardiac myocytes and increases collagen production in fibroblasts. 19 Several studies suggest that insulin resistance and/or hyperinsulinemia also contribute to concentric left ventricular hypertrophy and diastolic dysfunction in normotensives and hypertensives. 20,21 Blacks are at greater risk for developing hypertension related target organ disease than whites. Hypertensive blacks have a greater rate of decline of renal function over time than do whites, 22 and black men have a 4-fold-higher incidence of

show abstract

Effect of ethnicity and hypertension on atrial conduction: Evaluation with high‐resolution p‐wave signal averaging

Madu

Baugh²,

Gbadebo

et al. 2001

Clinical Cardiology

View full text Add to dashboard Cite

SummaryBuckground: Measurements by P-wave signal-averaged electrocardiogram (P-SAECG) of P-wave duration and Pwave voltage integral are higher in patients with atrial fibrillation (AF) than in those with sinus rhythm. Hypertension is perhaps the most common cardiovascular antecedent cause of AF, and particularly a disproportionate cause of morbidity and mortality among blacks. The purpose of this study waq to examine the effect of hypertension and ethnicity on P-SAECG parameters in patients without AF.evpothesis: It was hypothesized that P-SAECG parameters can identify hypertensives, and are disproportionately higher in hypertensive blacks.Merhods: In all, 234 normotensives and 84 hypertensives underwent P-SAECG analysis. In an ancillary study group of 34 hypertensive black men, the relationship between seventy of hypertension and measured parameters of P-SAECG was evaluated.Results: Mean filtered P-wave duration and total P-wave voltage integral for normotensives of both ethnic groups were similar. Hypertensive blacks had greater increase in Pwave duration ( I38 ? I6 vs. 132 ? I2 ms; p < 0.01, N 42:42) and total P-wave voltage integral (922 k 285 vs. 764 k 198 pV-ms; p < 0.00 1) than white hypertensives. Conclusions: Patients at very early stages of hypertension have demonstrable evidence of prolonged atrial conduction by P-SAECG and, thus, cardiac electrical remodeling. Pwave duration and total P-wave voltage integral increase with seventy of hypertension. Hypertensive blacks manifest a greater increase in P-SAECG parameters than whites. This may portend an increased cardiovascular risk for black patients with hypertension.

show abstract

Racial Differences in Ambulatory Blood Pressure and Echocardiographic Left Ventricular Geometry

Cited by 14 publications

References 27 publications

Race and Diurnal Blood Pressure Patterns

Race and Diurnal Blood Pressure Patterns

Predictors of Target Organ Damage in Hypertensive Blacks and Whites

Effect of ethnicity and hypertension on atrial conduction: Evaluation with high‐resolution p‐wave signal averaging

Contact Info

Product

Resources

About